Those small, pearly-white bumps under your eyes are almost certainly milia, tiny cysts filled with keratin (a protein your skin produces naturally) that become trapped just beneath the surface. They’re harmless and painless, but they don’t pop like pimples, and squeezing them only makes things worse. The good news: milia can be treated at home with the right products or removed quickly by a dermatologist.
What Milia Actually Are
Each bump is a miniature cyst, typically 1 to 2 millimeters across, sitting in the uppermost layer of skin. They form when keratin gets trapped inside a blocked hair follicle opening. Research suggests milia may originate from the outermost cells of the hair’s outer root sheath, which is why they’re so superficial. They show up most often on the cheeks, around the eyes, and along the nose, and they’re especially common in older women.
Unlike acne, milia have no opening to the surface. That’s why you can’t squeeze them out the way you would a whitehead. There’s no pore to push through, and attempting it risks scarring or infection in the delicate under-eye skin.
Common Causes
Heavy skincare products are one of the most frequent triggers. Thick occlusives like shea butter, petroleum jelly, beeswax, and heavy mineral oils can form a seal over the skin that traps keratin underneath. Eye creams with a rich, buttery texture are particularly problematic because the skin around your eyes is thinner and more prone to clogging than the rest of your face.
Sun damage, minor skin injuries (like burns or rashes), and certain topical steroids can also trigger milia by disrupting the normal shedding process of skin cells. Sometimes they appear for no identifiable reason at all.
At-Home Treatments That Work
Topical exfoliants are the most effective over-the-counter option. Three ingredients to look for:
- Salicylic acid dissolves the buildup inside pores and encourages skin cell turnover.
- Glycolic acid works on the skin’s surface to thin the layer trapping the cyst.
- Adapalene (sold as Differin), a retinoid originally designed for acne, speeds up cell renewal so trapped keratin can work its way out.
Be realistic about the timeline. Milia often take months of consistent product use to resolve, and you’ll need to keep using these products long term to prevent new ones from forming. Apply them carefully around the eye area, starting with a small amount every other day to avoid irritation. The skin under your eyes is sensitive, and retinoids in particular can cause dryness and peeling at first.
Whatever you do, don’t try to extract milia yourself. Picking or poking at them makes infection and permanent scarring far more likely. Unlike a pimple, there’s no easy way to release the contents without breaking through intact skin.
Professional Removal Options
A dermatologist can remove milia in a single office visit. The most common method is manual extraction: the doctor nicks the surface of each bump with a small blade, then gently presses out the intact cyst using forceps or a specialized tool. Patients typically experience minimal pain and bleeding, and the procedure takes only a few minutes.
For larger clusters or stubborn milia, dermatologists may use electrodesiccation (a small electric current that destroys the cyst) or laser therapy. These options work well but carry a slightly higher risk of temporary redness or pigment changes, especially on darker skin tones.
Professional removal is considered cosmetic, so insurance won’t cover it. Prices vary by location, but expect to pay at least $300 in a major city. If cost is a concern, starting with topical exfoliants at home and reserving professional extraction for milia that won’t budge is a reasonable approach.
Preventing New Bumps
Switching your eye cream is often the single most effective prevention step. Swap heavy, occlusive formulas for lightweight hydrators built around hyaluronic acid or glycerin. These ingredients pull water into the skin without adding oil or forming a suffocating barrier. Look for products labeled non-comedogenic, and avoid anything listing shea butter, petrolatum, beeswax, or thick plant waxes high in the ingredient list.
Regular gentle exfoliation also helps. Using a glycolic or salicylic acid product a few times a week keeps dead skin cells from accumulating and blocking follicle openings. Wearing sunscreen daily protects against the UV damage that contributes to milia formation over time.
When It Might Not Be Milia
Two other conditions look similar but require different treatment. Syringomas are firm, yellow or skin-colored bumps that form in clusters, typically 1 to 3 millimeters across. They’re benign sweat gland growths, not keratin cysts, and over-the-counter exfoliants generally won’t remove them. Syringomas require professional removal through electrosurgery, laser therapy, or excision.
Xanthelasma are flat or slightly raised yellowish patches, usually larger than milia, that appear on or near the eyelids. They’re deposits of cholesterol under the skin and can signal elevated blood lipid levels worth checking with a blood test.
If your bumps are yellow rather than white, larger than a couple of millimeters, or arranged in distinct clusters of uniform size, you may be dealing with one of these conditions rather than milia. A dermatologist can tell the difference with a quick visual exam.